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    IVF Risks May Outweigh Benefits

    ICSI Sperm Injection into OocyteSince the advent of in vitro fertilization (IVF) in 1981, over two million babies have been born using the fertility treatment. However, a team of experts from the Centre for Reproductive Medicine at the University of Amsterdam in the Netherlands believe that the treatment may be overused and that the risks of IVF outweigh the benefits.

    In vitro fertilization is a fertility treatment that involves combining eggs and sperm outside the body and then placing the embryo in the uterus. IVF was originally developed as a treatment option for women who had fallopian tube disorders and men who were severely infertile.

    One million babies were born using IVF between 1981 and 2003. The rate increased to two million by 2005.

    In a new analysis published in the journal BMJ, researchers led by Dr. Esme I. Kamphuis argue that IVF has been overused for other conditions that affect fertility including as a treatment for unexplained fertility problems.

    Between 2000 and 2010, the number of annual IVF cycles increased from 90,000 to 150,000 in the United States. However, during the same time period, the proportion of IVF cycles for tubal problems reduced from 25 percent to 16 percent, meaning that the fertility treatment was not being used as originally intended.

    The researchers also note that unexplained infertility accounts for 25 to 30 percent of couples undergoing IVF treatment. However, when not treated with IVF immediately, most of these couples eventually conceive naturally.

    State the researchers in the present study:

    “In a cohort of 500 Dutch subfertile couples with on average almost 2 years of unexplained subfertility, 60% conceived naturally after the initial assessment in the fertility clinic. Other observational studies have confirmed natural conceptions in couples with subfertility for 2-3 years.

    “It seems that a short delay in treatment does not affect ovarian reserve in such away that more couples will end up childless.”

    The researchers also note two problems with current IVF statistics: Most research on the IVF success does not state the duration for which the couple had been trying to conceive, and many countries do not collect data on infertility duration.

    More importantly, the experts argue that the use of IVF increases the risk of harm to both mothers and babies.

    Argue the researchers:

    “Multiple pregnancies are associated with maternal and perinatal complications such as gestational diabetes, fetal growth restriction, and preeclampsia as well as premature birth. And even singletons born through IVF have been shown to have worse outcomes than those conceived naturally.”

    Another recent comprehensive study from researchers at the University of Adelaide in Adelaide, Australia published in the journal PLOS One concluded that the use of assisted reproductive therapies including IVF increases the risk for serious birth complications including stillbirth, preterm birth, low birth weight, and neonatal death.

    There are also concerns about the long term health of individuals conceived using IVF. Babies conceived through IVF have an increased risk of higher blood pressure, adiposity, glucose levels, and more generalized vascular abnormalities than babies conceived naturally.

    The experts add that the health problems of individuals conceived using IVF appear to be directly related to the IVF procedure rather than any underlying issues affecting fertility.

    Unfortunately, because the use of IVF and other fertility treatments have evolved into a huge money-making business, there is little interest in funding studies that investigate the long term safety of the procedures:

    “IVF has evolved in many parts of the world as a profit-generating industry that values the money brought in by immediate gains of pregnancy and live birth over long-term considerations about the health of the mothers and children.”

    The experts conclude that IVF should still be an option for treating infertility. However, couples considering the treatment must understand the associated risks.

    Conclude the researchers:

    “As a society we face a choice. We can continue to offer early, non-evidence based access to IVF to couples with fertility problems or follow a more challenging path to prove interventions are effective and safe and to optimize the IVF procedure.

    “We owe it to all subfertile couples and their potential children to use IVF judiciously and to ensure that we are first doing no harm.”

    Additional research needs to be conducted on the long term outcomes with IVF.

    References

    Are we overusing IVF?: http://www.bmj.com/content/348/bmj.g252
    IVF: risks may outweigh benefits, say experts: http://www.medicalnewstoday.com/articles/271785.php

    Image Credits

    ICSI Sperm Injection into Oocyte: https://commons.wikimedia.org/wiki/File:Icsi.JPG

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